Guidewires are routinely used in medical procedures where a catheter is introduced into a patient's blood vessel such as an artery or vein. In cardiovascular procedures such as angioplasty, usually a guide catheter and a guidewire are inserted into the patient's blood vessel and advanced until the distal end of the guidewire reaches the location to be treated. Once the guidewire is in position, a catheter is slid over the guidewire and advanced until the catheter is positioned with its distal end at the diseased location within the patient.
During certain cardiovascular procedures, it may be desirable to change the in situ catheter. For example, a physician may use several balloon dilatation catheters having balloons of progressively increasing size to open a stenosis in the patient's artery. It is important to perform such a catheter exchange without moving the position of the guidewire from the location to be treated so that the guidewire can be used to direct the new catheter to the same location.
One often practiced method of exchanging catheters is to attach one end of an extension guidewire to the proximal end of the in situ guidewire and withdraw the catheter over the extension guidewire while leaving the in situ guidewire in place. A new catheter can then be advanced over the coupled guidewires, and the extension guidewire can be disconnected after the new catheter is placed at the location to be treated within the patient's vessel.
A disadvantage with this method is the difficulty in the physician's or nursing attendant's handling and manipulation of the extension guidewire and new catheter under the conditions in which cardiovascular procedures are performed. The length of extension guidewires has been typically in the order of 125 cm. This length of guidewire, which extends from the proximal end of the in sit guidewire, makes its handling somewhat awkward when the physician or attendant is attempting to exchange catheters in an already crowded operating room. At least one person must hold the extension guidewire with both hands to keep it and the catheter from contacting non-sterile objects or the floor, and, thus, breaching the sterile environment. Another person must manipulate the catheters around the first person's hands, keep the catheters from contacting the floor and other non-sterile objects, and avoid displacing the in situ guidewire all at the same time. As a result of these difficulties, the procedure of exchanging catheters is tedious, painstaking, time consuming and has some risk of displacement of the in situ guidewire.
Another disadvantage with this method of exchanging catheters is the problem of maintaining effective sterility, even if contact with non-sterile objects is avoided. Once the extension guidewire and the new catheter are removed from their sealed, sterile containers for use, there is no effective barrier to bacteria. Accordingly, there is some risk of infection by exposing the elongate guidewire and catheter to the open environment. As can be understood, all of these difficulties and complications add to the spiralling cost of medical procedures using guidewires and catheters.
Thus, there is a need for a device which can facilitate the procedure for handling and exchanging catheters, and which can provide for the sterile storage of a catheter therein.
In view of the foregoing, it is an object of the present invention to provide a device for facilitating catheter handling during an exchange of catheters in surgical procedures.
It is another object of the present invention to provide a device for the sterile storage of a catheter before, during, and after a catheter exchange.
It is yet another object of the present invention to provide a device for facilitating the exchange of catheters in a sterile environment that is simple in design and use, and economical to manufacture.
The foregoing objects and advantages of the invention are illustrative only and are not intended to be exhaustive or limiting of the possible advantages of the invention. These and other objects and advantages of the invention will be apparent from the description herein or from practicing the invention described or as modified to include any variations which may be apparent to those skilled in the art.